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Evaluating Diabetic Foot Infections With The New IDSA Guidelines

Submitted by Warren S. Josep... on Tue, 05/29/2012 - 08:54

Warren S. Joseph DPM FIDSA

I promised I would post a link to the newly revised, updated Infectious Diseases Society of America (IDSA) Diabetic Foot Infection Guidelines as soon as they were available. Well, I am honored, proud and excited to be able to let readers know that after approximately six years in writing, multiple levels of peer review and well over 60 individual review comments, the IDSA has posted the newly revised guidelines on its Website.1 You can read the guidelines at http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_...[1] .

Those of you familiar with the 2004 document will immediately notice the changes. All IDSA Guidelines are now standardized to a “question, recommendation, evidence summary” format. Each committee had the assignment of determining which were the most critical questions that need answers.

In this case, we came up with 10 questions that cover everything from diagnosis to antibiotics, to osteomyelitis and wound care. There are 44 evidence-based recommendations that guide the clinician in the answers to those 10 questions. The evidence is then summarized and graded by the British Medical Journal “GRADE” system. This common sense approach matches the strength of the recommendation with the level of the evidence. We provide this in plain English. For example “Strong, Low” means the decision is based on a strong recommendation but a relatively low level of evidence.

I hope that you all find the new guidelines helpful in your management of these patients. I look forward to your comments.